ACCIDENTS——EMERG ENCIES——POISONS. 67 eettin" further up, and it can be hooked out with the bent end of a wire or bodkin. Should these measures not remove the foreign body, the child should at once bo taken to a Surgeon. Foreign Bodies in the Ear. Foreign bodies in the car are more troublesome to deal with. No effort to remove them with a probe, or any thing of the kind, should be made by any one, except a professional man, for fear of 'permanent injury to the ear. The head of the child, face down- ward, should be held firmly between the knees, and with a Matt- son's or Davidson Syringe a stream of tepid water should be in- jected into the car. The nozzle of the syringe should not be in- troduced into tlie cavity, as its presence may prevent the dropping out of the desired body after the water has been forced past and beyond it. Should this means not succeed, consult a Surgeon without delay. Insects sometimes get into the car. The best way of getting them out is to hold the head of the person with the disabled ear upward, and fill the cavity with sweet-oil or glycerine. It drowns the animal, by closing up its breathing pores, and in a short time it floats to the surface of the fluid used. The tube of the ear is somewhat curved, and when straightened somewhat by catching hold of the upper tip, and gently pulling it upward towards the crown of the head, the liquid flows in more readily. BLEEDING FROM THE NOSE. Bleeding from the nose is sometimes troublesome, but not often fatal. Professional assistance can usually be had, .and if not, the remedies and appliances to be used, can not be properly described here. The most important thing is not to disturb the forming clot involving and closing the little ruptured vessel?, by blowing the nose. 68 ACCIDENTS——EMERGENCIES——POISONS. SPITTING OF BLOOD Often proceeds from the bnck of the throat, having trickled down and brought up by tho movement of cougliing. If the blood comes from the lungs, it is suggestive of trouble there, but not always so in young people, especially in young women. The amount of blood lost is rarely in itself fatal. As salt is always given in such cases, it has acquired a good deal of popular con- fidence for arresting the loss of blood. It and fragments of ice may be given. POISON-VINE ERUPTION. Several varieties of the Ehus, popularly known as the Swamp Sumach or Poison-Sumach, Poison-Vine, and Poison-Oak, when brought in contact with the skin of many persons, produce itch- ing, redness, a sense of burning, tumefaction, and even vesication. Sometimes the swelling is so great as to disguise the features. Persons coming within the influence of even the emanations from different species of the Rhus experience the same symptoms. The poisonous effects are usually observed shortly after exposure, and begin to decline within a week. Weak alkaline solutions—say a tea-spoonful of common baking soda to a quart of water, or even lime-water, kept to tlie part by dipping pieces of linen in them, arc useful in allaying tlie inflam- mation. Laudanum added relieves the pain. Weakcned-down Lead-Water is also recommended. Cream from milk is perhaps as useful as any thing else. FROST BITE. Exposure to the cold, of severe degree, often leaves the fingers and toes, nose and ears, and lips, more or less frozen. This condi- tion, short of absolute death of the part, is termed Frost Bite. It will be observed that the portions of the body just enumerated are those most exposed, in area, to the influence of the cold, and are furthest situated from the heart; and it will, perhaps be un- ACCIDENTS—EMERGENCIES—tOISONS. 69 necessary to remark that persons who are debilitated are more apt to suffer with the same amount of exposure than the robust. "When the circulation of any part begins to succumb to the in- fluence of the cold, it becomes puffy, blueish, and smarting. This is because the blood moves more slowly than natural through the vessels exposed near the surface. Soon this blueness disappears, and the part becomes pallid, as if the influence of the cold had contracted the vessels to an extent incompatible with the passage of blood through them. The pain at this point ceases; indeed, until lie meets a friend, he often does not know of his mishap. At this stage, the injury has become so great that, unless proper means are taken to restore circulation, complete death of the part ensues, and in due time sloughs away, and is detached from the line of living tissue. What takes place in a part of the body, known as Frost Bite, may take place in tlic whole of it, which is known as '' Frozen to Death." The blood of tlie extremities being gradually forced from them, under the continued subjection to the cold, is forced inward upon tlie larger blood-vessels, heart, lungs, and brain. There is increasing difficulty in breathing, owing to the engorged state of tlie chest, and, what would always be remembered by one so exposed to cold, an unconquerable' desire to sleep. To sleep then is to die. If tlie person exhibits such a symptom, he must, by all means, be kept constantly moving. Treatment. Persons exposed like those just described must be treated promptly, and with one thing never lost sight of. That is, keep the frozen person away from the heat. A person taken up insen- sible, or approaching it, from exposure to tlie cold, sliould be tak- en into a cold room, his clotliing removed, and thoroughly rubbed with snow, or cloths wrung out with ice-water. Tlio friction to every part of tlie body, particularly the extremities, must be con- tinued for some time, until signs of returning animation aupcar. ^ ACCIDENTS—EMERGENCIES— POISONS. When the frozen limbs show signs of life, the person should be carefully dried ; put in a cold bed in a cold room ; Artificial Re- spiration used, until the natural is established; then brandy given, also ginger-tea and beef-tea. Usually, by this time medical ad- vice will have been secured to direct further treatment. Should it not, do not forget that the patient is to be brought by degrees into rather wanner air ; and lest in some part there might still he defective circulation, (lie person sliould be kept away from expo- sure to the heat of tlie fire. Milder degrees of tlie same condition, as suspension of life in the ear, nose, finger, or toe, from exposure to cold, must be treated with the same general directions in view. The part sliould be kept away from the heat, and rubbed with handfuls of snow, or towels dipped in cold water, until circulation appears re-establish- ed. Exposure of the part to the heat before, we may say, it has been almost rebuilt, is apt to be followed by sloughing. CHILBLAIN, As the name implies, is when the circulation of the part lias be- come chilled-d/^rW, not destroyed. It is generally attended with much itching, tingling, and smarting, and is usually found in the toes, outside edge of the feet, just where tlie toe emerges, or in the licel. Sometimes, in persons of debilitated state of health, the hands suffer. Tliese symptoms are particularly annoying just after lying down in bed, owing to the exposure to the heated air formed and retained between the bed-clothing by the body. Tlie most useful thing for these annoying symptoms, and a con- dition which often extends into ulceration and sloughing, is to keep away from the fire, and every night, before retiring, to bathe the feet in cold water, or rub them with snow. They should then be well dried with a soft towel. After this, the application of the ordinary Compound Resin Ointment of the apotliecaries is often of use in stimulating the circulation through tlie part. Tlie efficien- cy or this ointment for this special purpose can be increased by ACCIDENTS——EMERGENCIES—POISONS. 71 asking the apothecary to add to an ounce of it a couple of drachms of the Oil of Turpentine. It may be remarked, that per- sons who suffer in winter from cold feet are often benefited to a surprising degree by bathing them at night, before retiring, in cold water. Such persons should always keep their feet away from the fire. CONVULSIONS. Convulsions, or "fits," as they are often called, are a frequent cause of alarm in the streets, or at public assemblages. In the decided majority of instances, the convulsions may be safely pre- sumed as Epileptic ; so, unless otherwise specified, the remarks here made apply to that form. Ordinary fainting may be con- founded with it; but here the face is pale, the person perfectly still, and there is no perceptible breathing. Besides, in fainting there is no convulsive movements. Often the Epileptic seizure is ushered in with a peculiar sharp cry, as the person falls over. It docs not always occur, but when it does there can be no doubt, if it is a convulsion at all, that it is Epileptic. There is frothing of the mouth, sometimes tinged with blood from the tongue or a fold of the lips having been caught between the teeth at the moment the spasm commenced in the muscles of the jaws. Sometimes there are general convulsive movements of the whole body ; often of parts of it only. At first the face is pale, but usually, in the course of a few moments, it becomes livid, except around the mouth, which often continues pale, in strong contrast witli the color of the rest of the face. As a general rule, it may be said that the convulsive feature of attack does not last much longer than four or five minutes, although to bystanders the time naturally seems longer. Then the person opens his eyes with a certain degree of intelligence, or revives enough to speak ; and, as will be said, it is at this point of the attack that most must be done. Sometimes there is nothing be- yond it, and tlie individual gets up, hurriedly puts on his hat, and walks off, apparently the least concerned of any body about. '- AOCtDfiNTS—fiMSBGENCIES—fOISONS. If this happy termination does not take place, this brief semi- conscious interval gives way to a A^y stupor, varying in duration from thirty minutes to three or even six hours. In Epileptic Convulsions, there is usually nothing to be done. Ignorant people on such occasions are apt, upon the general plea, "if you do not know what to do, do something," to insist upon "opening the hands," as the phrase is, saying that the patient will be better as soon as they can do it. The truth is, they can not do it until the patient is better. All interference of this kind is -hurtful, and no good can come of it. All rude efforts aggra- vate the trouble, perhaps, by exhausting still further the muscular strength of the patient. All that can be done is to keep the person from injuring himself or hurting others during the violent convulsive movements, by removing him to some clear space where there is nothing to strike against. Do not attempt even to hold the limbs, but loosen every thing about the throat and chest. Treatment. "Wait a few minutes for the convulsive movements to cease, and the semi-conscious state to appear. As said above, it will soon be seen. Then, if the person is a stranger, get his name and resi- dence, if possible, with such other knowledge as may be useful. In the mean while, keep the crowd away. This is a very impor- tant measure of assistance in convulsions, as in every other emer- gency. By this is not meant so tliat people can not bend over the victim, but that a. perfectly free space of at least two feet on each side should be kept, with none in it but the one or two imme- diately assisting him. Thirty drops of the Aromatic Spirits of Ammonia, in a tea- spoonful of water, may be given the patient, as it is thought by many physicians to lighten and shorten the later stupid stage. The spasmodic condition of tlie muscles of the jaws can usually be overcome enough, with a little gentle dexterity, to permit it to ACCIDENTS——EMERGENCIES—POISONS. 73 be got into the mouth with the assistance of another spoon or a piece of smooth stick. After getting the liquid into the mouth, press down the base of the tongue, and the mixture will readily run down the throat. As much of it will necessarily be lost dur- ing the operation, double the quantity may be prepared for use. If more than the thirty drops should be given, no trouble from it need be feared. If the name and residence have been secured, as it often can, at the interval alluded to, the friends of the person can be advised. If not, lie should be taken to some place of security until con- sciousness returns. Persons liable to Epileptic Convulsions should never be permit- ted to go from the house without a strip containing the name, re- sidence, and disease, attached inside of the coat, where it will at once be seen upon unbottoning the coat over the chest. A refe- rence on it to a memorandum in some pocket containing a sugges- tion as to the duration of the attack, useful remedy, if any, in as- sisting restoration, would often materially add to the comfort and advantage of the afflicted person. Other Convulsions are Apoplectic. These are not common, in comparison with others. As a rule, little can be done by bystan- ders, farther than loosening every thing about the neck. This should be done in all Convulsions. The Convulsions known as Hysterical are usually found in young women who are not very strong. Until assistance comes, act as directed in Epileptic Convulsions. The distinction be- tween them can not be expressed, to a useful extent, to unprofes- sional persons. RHEUMATISM AND NEURALGIA. Persons susceptible to Rheumatism or Neuralgia are often liable to an attack, which as completely disables them as a broken bone. When Rheumatism is here spoken of, it does not mean Inflammatory 74 ACCIDENTS——EMERGENCIES—POISONS. Rheumatism, but the other troubles with similar symptoms and immediate results, but possibly of a different origin. A person constitutionally disposed, or who has acquired Rheuma- tism, can never be too careful of himself. Every thing like exposure of the surface of the body, especially the soles of the feet, to currents of cold air, or to cold surfaces, must be avoided. Warm suits of inside flannel, with plenty of buttons, should be put on early and taken off late. The predisposed often favor an attack by allowing garments of muslin or linen, when moist with perspiration, to dry upon the skin. Tlie quiet chill, some- times evident, from the rapid evaporation, can be avoided, and with it, what it leads to ; by wearing flannel next to the skin all the year round. Many people known to the writer have been remarkably benefited by wearing suits of buckskin undercloth- ing over their muslin inside shirts and drawers. Not only invalids suffering from Rheumatism, but debilitated persons, and known as the somewhat aged, have been relieved to a surprising degree of distressing wandering pains and other like symptoms, by hoarding the heat of tlic body by such suits.* Heavy soles to the boots, which may even be warmed inside be- fore putting on, should be used. It may here be remarked that, in changing the boots, during the day, for another pair, it is often better to keep on the wet ones if they are warm than to chill the moist feet with a pair that are dry, but cald. These arc little things, but very important to people who dislike to be sick. The digestion is often poor in persons suffering with what is known as Neuralgic Rheumatism, and improves on attention to preserving the heat of the body. Every thing said here about Rheumatism applies to general as well as local Neuralgia. The pain of Neuralgia has been said by a celebrated German physician to be the " prayer of the nerve for healthy blood." * They can be had of most furnishing stores. ACCIDENTS—EMERGENCIES—POISONS. 75 CHOLERA. In the early spring of almost every year, a visit of this epide- mic is predicted from some source, and every few years cases enough occur to justify the sagacity involved. The general na- ture of the malady even is unknown, and the treatment wholly empirical. One thing can be asserted -without dispute, and that is, want of cleanliness, overcrowding and bad water, not only invite tlie malady, but at the same time increase its fatality. Where cholera is to be feared, the strictest attention should be paid each of these favoring causes. All, except tlie latter, may be evident to the senses, but often there is no known means to or- dinary persons of detecting the latter. Cholera and other epi- demics quickly and effectually solve the problem of overcrowd- ing- Water of surface, origin, never mind how far down the bottom of the well ; or likely to be contaminated with sewer or kindred emanations, should be carefully avoided. If nothing better can be done, the water from melted Northern ice can be used for drinking purposes. If this is not to be had, ordinary water can be boiled under cover, for a few moments, to destroy the animal and vegetable features. "Filtering" water does not necessarily " purify" it in the popular sense, but merely strains out particles too big to pass. What is left often is the dangerous element. Heat destroys that, and with the exception of a little "flatness" to the taste, the water is quite palatable. In the absence of some- tiling better in traveling, water can be thus prepared for drinking by heating in a cup over the flame of gas or a lamp. Nothing likely to invite or force the blood to the mucous mem- brane must be permitted. Hence, all indigestible articles, or of difficult digestion, must be avoided. Meals, after fatigue, unless of easy digestion, must be avoided, and especial care should be paid the late meal of the day, when at all times there is less strength than earlier. Articles of any kind, even although tolera- ted by the stomach in robwt health, may prove irritating in warm 76 ACCIDENTS——EMERGENCIES——POISONS. weather, when Cholera prevails. The usual debility of the late sum- mer, especially if the nights are cold, permits exposure while sleeping, to bring about congestion of the bowels and relief as a diarrhoea ; just as the debility of late winter, under the influence of exposure, favors congestion of the lungs and relief to the mu- cous membrane there as expectoration. When an epidemic exists, all related affections assume the gen- eral features of the prominent disease ; and it is noticed that when Cholera exists, the most trifling irregularity, in a greater or less de- gree, assumes the well-known symptoms of that disorder—show- ing, it is said, the prevalence in the' blood, perhaps of every body, of a fractional part of the requirement of that poison necessary to constitute a pronounced case of the malady. "What is wanting, indiscretion can provide. The treatment really should begin with the slightest appearance of a relaxed condition of the bowels. With this there must be a studious avoidance of every thing known to increase it. The gen- eral disposition seen during the epidemic, to this state of things, is known as''Choleraine," and a slight neglect will lead to an at- tack of Cholera, A tea-spoonful of Paregoric, with ten drops of the Tincture of Ginger ("essence of ginger" may answer), can be taken by an adult, every hour or so, until »elief is felt. The attack is ushered in with symptoms more or less like the ordinary diarrhosa. They soon become more urgent, and in a short time follow cramps and profuse evacuations of "rice-water" liquid. The entire watery portion of the blood seems to be rap- idly passing off in this shape, leaving the blood viscid, darker in color and lessened in quantity. The changed circulating fluid gives the skin, particularly of the face, quite a dark color, and na- turally enough, under the circumstances, a sliriveled look. As should be expected also, the skin and the entire body seem quite cold. The latter symptoms, together, give what is known as " col- lapse," and the person probably dies, from the blood circulating so